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Republicans are weighing a repeal of a key tenet of the Obama-era health care law in their tax overhaul as the House's tax-writing committee begins work on shaping the bill. Speaker Paul Ryan said Sunday Republicans are discussing whether their tax plan should include a repeal of the Obama health law's requirement that people have insurance coverage or face a penalty, a step pushed by President Donald Trump but seen by some GOP lawmakers as possibly imperiling a much-needed legislative victory. (11/6)

Conservatives are attempting to revive efforts to gut Obamacare’s individual mandate as part of the Republican overhaul of the tax code. But the House's top tax writer, while leaving the door open to a measure President Donald Trump supports, said Friday that such a move would complicate the tax package's prospects, particularly in the Senate. (Demko and Cancryn, 11/3)

President Donald Trump has been lobbying hard to ensure a repeal of the individual mandate makes it into a tax overhaul before a bill reaches his desk. House Ways and Means Chairman Kevin Brady said Trump has talked to him about it twice by phone and once in person. (McPherson, 11/3)

Health care industry lobbyists are watching closely to see if tax writers may add a repeal of the requirement to get medical coverage to the House tax bill. A key committee chairman suggested Friday that it is a possibility, as conservatives and the president push for its inclusion. The issue is one of several the industry is monitoring in the bill. House Ways and Means Chairman Kevin Brady, R-Texas, said he expects to release on Monday another version of the bill with substantial changes. He said Friday that tax writers asked congressional scorekeepers for an updated cost estimate of the provision. (McIntire, 11/3)

When Diane Thorsen began to show signs at an early age of the Alzheimer’s disease that had stolen her mother’s mind, she and her husband, Richard Davis, were as ready as they could be. They sold their house in California to prepare for the cost of care and moved to Minnesota to live with one of Thorsen’s daughters. Davis planned their finances methodically; once Thorsen’s long-term care insurance ran out, the daunting $98,000 bill for her nursing home would be manageable — because they could deduct medical expenses from their tax bill. (Johnson, 11/4)

It’s Open Enrollment time for health insurance and for those choosing their insurance on the federal marketplace there is interesting news for Wyoming residents. Subsidy payments for those in the marketplace have increased and so in many cases, people can get more affordable and possibly better coverage. (Beck, 11/3)

Tens of thousands of Coloradans who could be eligible for free or reduced-cost health insurance instead pay a fine every year for not having insurance at all, according to a new report from a nonpartisan health group. The issue, for many, is the price of insurance. Especially in rural areas of the state, the cost of insurance — even if it is reduced by federal tax subsidies — can still be many times more than the cost of paying the fine, said Joe Hanel, the manager of public policy outreach at the Colorado Health Institute and the report’s author. (Ingold, 11/3)

The language is startling: a nearly $400 monthly premium increase for a New Hampshire 2018 health insurance plan over last year’s rates. A letter sent recently by an insurance provider to a New Hampshire resident states that in contrast to the $237 monthly premium the consumer paid in 2017, the cost of that plan next year would shoot to $630 a month if they chose to stay on – despite their federal subsidies. (11/4)

A year ago, Bhagirath Khatiwada had four health insurance navigators on the payroll. His organization, the Manchester-based Building Community in New Hampshire (BCNH), helps sign Granite Staters up for insurance plans on the individual market; the trained navigators play a vital role. But then came a leadership change in the White House – and in health care policy broadly. After the Trump administration made sweeping cuts to outreach and assistance programs for the Affordable Care Act, Khatiwada’s organization saw a 60 percent cut in grant funding. (DeWitt, 11/5)

The House passed a bill on Friday that would provide five years of funds for the popular Children’s Health Insurance Program, over vehement objections from Democrats who opposed the way it would be financed. The vote, 242 to 174, came a month after funds for the program expired. (Pear, 11/3)

After months of disputes and delays, the House voted Friday to renew funding for the Children’s Health Insurance Program, community health centers and other public health programs. The legislation passed easily, 242-174, although many Democrats opposed the measure due to disagreements over the offsets. ... Advocacy organizations and state officials have been clamoring for Congress to act to extend funding for CHIP, community health centers and a number of other safety net programs. Most still had some money to keep operations going after the Sept. 30 expiration date, but officials are increasingly nervous about running out. In the case of CHIP, federal health officials have been funneling some leftover funds to the states that are in the most dire situations. (Raman, 11/3)

The House bill would charge higher premiums to wealthier Medicare beneficiaries, cut money from ObamaCare’s public health fund and shorten the grace period for ObamaCare enrollees who fail to make premium payments. According to an analysis by the left-leaning Center on Budget and Policy Priorities, between 259,000 and 688,000 people could lose their insurance as a result of the shortened grace period. (Weixel, 11/3)

It’s funded by taking money from the Prevention and Public Health Fund, a program under the Affordable Care Act that finances public health efforts and tries to improve quality of care. It also limits federal subsidies to Medicare beneficiaries making more than $500,000. (Rausch, 11/3)

It now heads to the Senate where lawmakers are working on an entirely different approach to re-authorize the Children’s Health Insurance Program, often called CHIP. (Torry, 11/3)

Anthem Inc. Chief Executive Joseph R. Swedish will step down, and veteran managed-care executive Gail K. Boudreaux will take over as the insurance giant’s next leader Nov. 20. Ms. Boudreaux will take the titles of chief executive and president, the company said. She will also join Anthem’s board. Mr. Swedish will remain as executive chairman until May 2018 and will be a senior adviser through May 2020. (Wilde Mathews, 11/3)

A statement Monday from Indianapolis-based Anthem gave no reason for the departure of Swedish, who has led the insurer for more than four years. Boudreaux, 57, served as a CEO of UnitedHealthcare, the health insurance arm of UnitedHealth Group Inc., until November 2014. (11/6)

Swedish will serve as Anthem’s executive chairman and step down from that role in May next year. He will be senior adviser through May 2020, the company said. Swedish orchestrated Anthem’s $54 billion merger proposal to smaller rival Cigna Corp (CI.N) in 2015, which was ultimately scrapped due to regulatory issues. (11/6)

Swedish's career in healthcare spans more than four decades. He has worked for Indianapolis-based Anthem, a licensee of the Blue Cross and Blue Shield Association, since 2013 when he replaced Angela Braly as president and CEO. He became chairman in 2015. (Livingston, 11/3)

Kaiser Permanente reported double-digit increases in operating revenue, operating income and net income in the third quarter of 2017 compared with the year earlier period. Operating revenue for the Oakland, Calif.-based hospital and health plan giant climbed 11.5% to $18.3 billion from the prior-year quarter. In the same period, operating income grew 20.9% to $850 million. (Barr, 11/4)

President Trump declared that the shooting in Sutherland Springs, Tex. that left at least 26 people dead was not “a guns situation,” saying instead he believed that “mental health” was the problem. Trump’s comments came at a news conference in Tokyo, when he was asked about the shooting at a South Texas church and if stricter gun laws were the answer. (Parker, 11/6)

“This is a mental health problem at the highest level,” the president said during a press conference with Japanese Prime Minister Shinzō Abe when asked what policies he would propose in response to the tragedy. “This was a very deranged individual,” Trump said, adding, “We have a lot of mental health problems in our country, as do other countries. This isn’t a guns situation.” (Restuccia, 11/6)

The rate of gun deaths in the United States rose in 2016 to about 12 per 100,000 people, the Centers for Disease Control and Prevention said in a report released on Friday. That was up from a rate of about 11 for every 100,000 people in 2015, and it reflected the second consecutive year that the mortality rate in that category rose in the United States. (Hauser, 11/4)

Deaths by drug overdose in the United States surged last year by more than 17 percent over 2015, another sign of the growing addiction crisis caused by opioids, according to a report released Friday by the Centers for Disease Control and Prevention. Preliminary data from the 50 states show that from the fourth quarter of 2015, through the fourth quarter of 2016, the rate of fatal overdoses rose to nearly 20 people per 100,000 from 16.3 per 100,000. (Kaplan, 11/3)

A Chinese narcotics control official played down China’s role in the distribution of synthetic opioid drugs, though U.S. President Donald Trump has vowed to press the issue at a summit in Beijing next week. Wei Xiaojun, a top officer in the Ministry of Public Security’s Narcotics Control Bureau, told reporters on Friday that Beijing is determined to stem exports of drugs like the opioid fentanyl that are made in China. (Areddy and Dou, 11/3)

Just a few months after Boston Mayor Marty Walsh was elected four years ago, the state declared the opioid crisis an emergency. Walsh said because of his personal experience in recovery, he was well-suited to help address the epidemic. But now as he seeks re-election, some say his actions have made matters worse. (Becker, 11/6)

Construction workers in Ohio were seven times more likely to die of an opioid overdose last year than were workers in other professions, according to a Plain Dealer analysis that included records from more than 12,000 opioid drug overdose deaths in the state from 2010 through 2016. (Dissell, 11/5)

A bipartisan panel of lawmakers last week supported a package of six wide-ranging bills designed to prevent and treat the state’s drug overdose crisis, building on five years of work from Gov. John Hickenlooper’s administration to identify holes in the current system. The approach — which, according to experts, puts Colorado in the top tier among states nationwide for its response — has been boosted by a $35 million infusion from the federal government to test solutions to what President Donald Trump has labeled a national public health emergency. (Frank, 11/5)

In semi-private booths, each with a chair and a mirror, Denver heroin users could shoot up with clean needles, no threat of arrest and under the supervision of staff trained to jump in with a life-saving antidote in case of overdose. It would look more like a medical clinic than a party lounge, with floors and furniture that workers could hose down in the event of vomit or blood spills. Staffers would hand out sterile needles and possibly distilled water, but clients would bring their own drugs to cook and inject. (Brown and Murray, 11/5)

Along a narrow, winding river, a team of American scientists is traveling deep into the Congo rain forest to a village that can be reached only by boat. The scientists are from the Centers for Disease Control and Prevention, and they have embarked on this watery journey to solve a decades-old mystery about a rare and fatal disease: monkeypox. (Sun and Mara, 11/3)

Less than a year after the World Health Organization declared that Zika is no longer a public health emergency, the virus seems to have fallen from public consciousness, at least outside heavily affected areas. The ­mosquito-borne virus staged a massive assault on the Western Hemisphere in 2015 and 2016, but this year, Zika appears to be in retreat. (Cunningham, 11/4)

A new case of sexually-transmitted Zika in Miami-Dade County was confirmed by the Florida Department of Health on Friday. The individual’s partner was infected with Zika while traveling to several countries, including Cuba. (Miller, 11/3)

Nearly 40% of American adults and 20% of children carry enough extra weight to warrant a diagnosis of obesity. That’s the highest obesity rate among the world’s affluent nations, and it’s already shortening Americans’ lifespans by driving up rates of diabetes, heart disease, stroke, cancers, arthritis and dementia. (Healy, 11/3)

When Jason Lalli tore his left anterior cruciate ligament at age 26, he thought he would be fine as soon as he had his knee repaired. As a soccer player who competed through college and then on recreational teams, he knew that A.C.L. injuries could be debilitating but also that orthopedists could fix them. He figured that he would miss a season, but that he could play and coach the game he loved for the rest of his life. (Kolata, 11/6)

Diabetes devices may be having their iPhone moment. For decades, the daily routine of diabetics involved painful needles, finger-pricking lancets and imprecise glucose meters. Now, manufacturers have begun incorporating the slick and consumer-friendly designs of Silicon Valley, linking to phones and other tech devices. (Rausch, 11/3)

Patrick Soon-Shiong, the medical entrepreneur who has expanded his influence in Washington by cultivating close ties to both parties, has struggled to meet analysts’ expectations for sales of his GPS genetic test, the key to his plan to transform cancer treatment by matching patients with tailored drug treatments. At the same time, sales of the GPS test are being boosted by purchases from hospitals and clinics associated with doctors who have financial ties to his network of for-profit and non-profit companies. (Tahir, 11/4)

This summer, Dr. Ben Kruskal learned firsthand about the famously hellish pain that comes with shingles, the blistering rash that afflicts one in three Americans, usually later in life. "There was a sort of a baseline pain that is not easily described but very, very unpleasant," he said. And "an extreme sensitivity to touch, such that even a very light touch in certain areas of my face was exquisitely painful." Weeks later, "I'm back to normal," he said, "and that is something I'm devoutly grateful for." (Goldberg, 11/3)

Kaiser Health News: Sickle Cell Patients Suffer Discrimination, Poor Care — And Shorter Lives

For more than a year, NeDina Brocks-Capla avoided one room in her large, brightly colored San Francisco house — the bathroom on the second floor. “It was really hard to bathe in here, and I found myself not wanting to touch the walls,” she explained. The bathroom is where Brocks-Capla’s son Kareem Jones died in 2013 at age 36, from sickle cell disease. (Gold, 11/3)

Two-thirds of kids drink at least one soda on any given day, according to a recent study from the Centers for Disease Control and Prevention. The bad news is that nearly a quarter of American children aged 12 to 19 have either Type 2 diabetes or prediabetes, according to a 2012 study in the journal Pediatrics. (D'Souza, 11/3)

A conservative goal of opening more of the Department of Veterans Affairs’ medical services to the private sector is due to get a push from the well-funded Koch brothers’ network. Brothers Charles and David Koch, whose network is planning to spend hundreds of millions of dollars to advance its conservative agenda across the government and protect vulnerable congressional Republicans, will mobilize several affiliates and subgroups to battle for its vision of the future of the VA, Koch representatives said this week. (Kesling, 11/3)

Among critics of the federal prohibition of marijuana — a diverse and bipartisan group that includes both criminal justice reform advocates and Big Alcohol — the American Legion and its allies stand out. For more than a year, the stalwart veterans group has been working to reframe the debate as a question of not only moral and economic imperatives, but also patriotic ones, arguing that access to medical marijuana could ease suffering and reduce suicide rates among soldiers who return from the horrors of war. (Ugwu, 11/3)

U.S. authorities released a 10-year-old immigrant girl with cerebral palsy who had been detained by border agents after surgery because she is in the U.S. without legal permission. The American Civil Liberties Union and U.S. Rep. Joaquin Castro said that Rosa Maria Hernandez was returned to her family Friday. Her parents brought her into the U.S. from Mexico in 2007, when she was a toddler, and they live in the Texas border city of Laredo. (11/4)

Federal immigration authorities released Rosa Maria Hernandez on Friday after more than a week in detention. A lawyer for the girl’s family confirmed to the Corpus Christi Caller-Times she was released to relatives from a San Antonio facility for undocumented minors. While he applauded the child’s release, U.S. Rep. Joaquin Castro noted that her future is uncertain because federal authorities have not determined whether she’ll be able to remain in this country. (Devall, 11/4)

Asking the Supreme Court to get involved, the Trump administration on Friday accused lawyers for the American Civil Liberties Union of misleading the Justice Department in the case of a pregnant immigrant teen who was able to obtain an abortion following a lawsuit. (11/3)

In a petition, HHS alleged that American Civil Liberties Union lawyers rescheduled an abortion for the undocumented 17-year-old soon after the D.C. Court of Appeals ruled in her favor, so it would be earlier than planned. ...HHS is now urging the Supreme Court to vacate the lower court’s ruling against the federal government and assert instead that the federal government has no obligation to facilitate abortions for unaccompanied minors in its custody. (Cancryn, 11/3)

Executives at Partners HealthCare and its largest hospitals are so concerned about a big Massachusetts health care bill that they’re asking employees to lobby against some of the legislation’s provisions. Partners executives sent e-mails to most of the organization’s 73,000 employees Friday, warning about the possible ramifications of the bill now making its way through the Senate. (McClusky, 11/3)

The Virginia state health commissioner recently approved the proposed merger between Mountain States Health Alliance and Wellmont Health System despite the Federal Trade Commission's opposition. Both Tennessee and Virginia approved the organizations' certificate of public advantage, or COPA, which essentially allows them to skirt challenges from federal regulators in favor of 10 years of state oversight while the companies integrate under Ballad Health. COPAs are used to demonstrate that a merger's public benefit outweighs potential anticompetitive consequences. (Kacik, 11/3)

The consulting firm running D.C.’s only public hospital came under growing pressure Friday as the hospital’s chief medical officer and a former executive who oversaw quality of care said the firm has disregarded patients’ safety in an effort to preserve a lucrative contract with the District government. Veritas of Washington faced intense criticism at a public hearing by the D.C. Council’s health committee, as Maria Costino, who until several months ago was United Medical Center’s director of quality management and patient safety, said the firm’s employees repeatedly sought to handicap her work. (Jamison, 11/3)

A federal judge in Kansas City on Friday denied Planned Parenthood’s request to block a Missouri regulation requiring its clinic in Columbia to have a so-called complication plan for medication abortions. The Legislature enacted the requirement this summer after Gov. Eric Greitens called it into special session. Later the Department of Health and Senior Services issued a rule that an OB-GYN had to be on call 24/7 to treat complications from a medication abortion. (Margolies, 11/3)

The clinic treats kids from newborns to age 18 — about 27,000 visits a year. It is funded by the Children’s Hospital Colorado Foundation, a past recipient of the Post’s Season to Share campaign. The clinic focuses on disease prevention and health maintenance. Services include hearing and vision screening, nutritional counseling and laboratory testing. Mental health services, including consultations with behavioral health and psychiatry specialists, are also available. (McGhee, 11/5)

Citing a lack of beds and staffing concerns, a central Minnesota hospital says it's no longer accepting people committed by courts for psychiatric care. St. Joseph's Medical Center in Brainerd will admit to its 16-bed behavioral health center only those patients who are seeking treatment voluntarily. (Sepic, 11/3)

Authorities say that expertise is crucial because of the growing number of police calls involving people who are in the throes of a mental health crisis when the squad cars roll up. Of the 14 Minnesotans shot and killed by police in 2016, six were in the throes of some kind of mental health crisis. (Lillie, 11/3)

Ride-sharing drivers in Tampa Bay and beyond are noticing an uptick in rides to and from the emergency room as consumers try to avoid spending what could be thousands of dollars for an ambulance. It’s an updated version of a role long played by cabs. What’s new is that the ride-sharing experience, with its ability to tell people how soon a car will arrive, is seen by many as more nimble and better suited to a spur-of-the-moment decision like rushing to the ER. (Griffin, 11/6)

A hospice volunteer in Itasca County doesn’t want a flu shot and she may lose her volunteer job if she doesn’t get one. It’s apparently not enough if workers for Essentia Health cite religious beliefs for refusing flu shots. It wants workers to prove they live by religious doctrine in other aspects of their life too. (Collins, 11/5)

Flu-shot clinics; restaurant inspections; checkups for low-income mothers, infectious-disease contingency plans. For the last 70 years, Pennsylvania has been encouraging counties to create health departments to provide such services, calling local agencies the best way to promote the health of state residents. (Bond, 11/5)

Nearly everyone on Optimal's staff is a full-time employee with full benefits, which isn't always the case in home health care. Optimal is also fairly unique in the industry for offering its employees annual profit-sharing checks. These checks range in size from several hundreds dollars to several thousand dollars, Murphy-DeOrsey said. The company started focusing in recent years on employees' strengths in annual performance reviews, rather than page after page pointing out weaknesses, said Erik Wilson, Optimal's director of nursing. (Reindl, 11/4)

For agencies across central Ohio, the main strategy against spreading cold and flu is to encourage people to get a flu shot, stay home when they’re sick, wash their hands and contain sneezes. But the people responsible for keeping facilities in tip-top shape say that the work done by custodial staffs is another important step in the battle to prevent illnesses this time of year. (Viviano, 11/5)

In March 2016, Doreen Smith received a text message from her daughter’s teacher. It contained a picture of Rosa, her daughter, who has cerebral palsy. Rosa was grimacing as four pieces of tape covered her mouth. “Help. She won’t be quiet!!!!” the teacher wrote in a follow-up text message that included two emojis, according to court documents. (Phillips, 11/5)

Republicans are looking under every seat cushion to finance tax cuts and the political bribes that Members of Congress are demanding for their votes. One surprising potential “pay for,” believe it or not, would be repealing ObamaCare’s individual mandate. The IRS administers the mandate, which ObamaCare euphemistically dubbed an “individual responsibility payment.” But Chief Justice John Roberts called it a tax to declare it constitutional, so a policy and fiscal nexus exists. (11/5)

President Trump recently tweeted that GOP tax-writers should include a repeal of the Affordable Care Act’s individual mandate in their tax reform legislation. This is a singularly bad idea that most Republicans are likely to reject. (Senators Tom Cotton and Rand Paul are exceptions, having seconded Trump’s suggestion.) It would be irrational and unproductive at this point to import the fractious political combat associated with health-care reform into tax negotiations that are already loaded with controversies. (James C. Capretta, 11/6)

Despite the best efforts of the Trump administration and Republicans in Congress to destroy the Affordable Care Act, the law is not collapsing. And on Wednesday, Americans began signing up for health insurance policies for next year through the online exchanges created by that law. (11/4)

It’s hard to imagine anything less political than Americans’ everyday interactions with our health care system. Illness and accident don’t distinguish between Democrat and Republican. Neither do rising premiums, pre-existing conditions, or the fear that our loved ones might find themselves without insurance. Like it or not, our basic need for health care is something that unites us. (Mack McLarty and Tom Davis, 11/6)

I certainly understand that when people think their health care will be cheaper if it is government-run, this can be an appealing proposition. The reality throughout the world, however, tells a very different story in those single-payer systems. (Alan Preston, 11/4)

In recent years, how we deliver and receive health care in Montana has been transformed. ... One major reason for this was legislative action in 2015. Until then, far too many Montanans went to work every day with the knowledge that access to health insurance and a doctor or nurse practitioner was beyond their reach. ... Montana’s lawmakers saw what was happening in their communities and delivered a bipartisan compromise to expand Medicaid coverage to these low-income, working families, friends and neighbors. As a result, Montana’s uninsured rate has dropped from a staggering 20 percent in 2013 to 7 percent in 2017, and many rural hospitals struggling under the weight of uncompensated care were thrown a lifeline. (Dick Brown, 11/5)

In American culture, we have long feared aging and death. Other cultures have a different take: They honor and admire the elderly and even celebrate the end of life. For many of us in America, the end of life stage brings sadness, stress and fear. But perhaps we can learn from those other cultures that take a healthier approach. One major factor that influences our perception about aging is the prevalence of Alzheimer’s disease – a condition that impacts more than five million Americans, and is the sixth-leading cause of death in America today. (Mauri Malka, 11/4)

Missouri Attorney General Josh Hawley last week said he will appeal a judge’s order that the state catch up with $26.3 million in back payments owed to 3,000 citizens who are totally blind. For financial reasons, as well as reasons of simple compassion, Hawley should rethink the appeal. The state does not dispute that it owes the back payments, which stem from the late 1990s and early 2000s. Four previous appeals over how the payments are calculated have settled the issue. In the latest judgment, made public Oct. 8, Cole County Circuit Judge Patricia Joyce figured the state’s bill at $26.3 million. (11/5)

Over the past 10 years, the District has spent $179.7 million on the United Medical Center in Southeast Washington. What it has gotten in return is a perennially troubled hospital that has done little to meet the real health needs of residents in Wards 7 and 8. That experience — along with its calamitous operation of the old D.C. General Hospital — should have taught the city to stay out of the hospital business. Instead, officials are blithely talking about spending as much as $330 million to build a new hospital. (11/5)

House cleaning to guarantee the safety and care of military veterans in Missouri shouldn’t stop with the St. Louis Veterans Home. It needs to include Larry Kay, head of the Missouri Veterans Commission. Kay hired administrator Rolando Carter, who had a troubled background and is now accused of presiding over a dangerously declining state of care at the home. (11/4)